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                   NAVODAYA VIDYALAYA SAMITI
   (An autonomous Organisation under Ministry of Human Resource Development)
                  Department of School Education and Literacy
                                 Govt. of India
                             A-28, Kailash Colony,
                                     NEW DELHI – 110 048.


No.F.1-18/2001-NVS(Admn)                                     30 May, 2008


                               NOTIFICATION


      In exercise of powers conferred under clause (i) of sub-rule (ii) of
Rule 24 of the Rules of the Navodaya Vidyalaya Samiti, the Executive
Committee of the Samiti has framed „Navodaya Vidyalaya Samiti Payment
of Gratuity Rules 2007‟ for     regulating payment of gratuity to the
employees of the Samiti. A copy of the said Rules is enclosed.

      These Regulations will be applicable to the employees of the
Navodaya Vidyalaya Samiti till such time the Payment of Gratuity Act,
1972, is amended to include teachers for gratuity benefits. Thereafter the
Samiti will either follow the amended Payment of Gratuity Act or seek
exemption from the Act under Section 5 of the Act if it wishes to continue
under these Regulations.

       These Regulations will come into force with effect from the date of
this notification. All cases relating to payment of gratuity to the employees
of the Samiti will, henceforth, be determined as per these Rules.



                                                              (M.S. Khanna)
                                                    Joint Commissioner (Pers)
Copy to :


   1.       PS to Hon‟ble HRM and Chairman, NVS
   2.       PS to Hon‟ble MOS(HRD) and Vice Chairman, NVS
   3.       All Jawahar Navodaya Vidyalayas
   4.       All Regional Offices of NVS
   5.       All Officers at NVS Headquarters
   6.       Under Secretary (UT-1), Department of School Education &
            Literacy, Ministry of Human Resource Development w.r.t. letter
            No.F.20-23/2006-UT.1 dated 21st May, 2008.
                                                                             1


                NAVODAYA VIDYALAYA SAMITI

             PAYMENT OF GRATUITY RULES, 2007


      In exercise of the powers conferred by clause (i) of sub-Rule(ii)
of Rule 24 of the Rules of Navodaya Vidyalaya Samiti, the Executive
Committee of the          Navodaya Vidyalaya Samiti, hereby make the
following rules, namely:-


I.    Short title, commencement and application:

      i)       These regulations may be called the “Navodaya Vidyalaya
               Samiti Payment of Gratuity Rules, 2007.


      ii)      These regulations shall be deemed to have come into
               force with effect from the date of their notification.


      iii)     These   regulations   shall   apply   uniformly   to   all   the
               employees working in the Navodaya Vidyalaya              Samiti
               [NVS] Hqrs., its Regional Offices, Navodaya Leadership
               Institutes and Jawahar Navodaya       Vidyalayas.



II.        Definitions:


      In these regulations, unless the context otherwise requires:


      1.       “Samiti” means Navodaya Vidyalaya Samiti.

      2.       “Employee” means regular employee of the Samiti.

      3.       “Completed year of Service” means continuous service
               for one year.

      4.       “Form” means a form appended to these rules.

      5.       “Continuous Service” means
                                                                2

     An employee shall be said to be in continuous service for
     a period if he has, for that period, been in uninterrupted
     service, including service which may be interrupted on
     account of sickness, accident, leave, absence from duty
     without leave not being absence in respect of which an
     order treating the absence as break in service has been
     passed in accordance with the rules or regulations
     governing the employees of the Samiti.


6.   “Controlling   Authority”     means   following      officer/
     authority   nominated   by   the   Samiti   who   shall   be
     responsible for the administration of these rules.



     Category of Employees          Controlling Authority

     All   Teaching    &   Non- Deputy Commissioner of
     Teaching Staff of ROs/JNVs concerned Regional Office.
     (Up to the level of Vice
     Principals)

     All               Assistant    Deputy      Commissioner
     Commissioners, Principals,     (Admn.),       Navodaya
     Section     Officers     &     Vidyalaya        Samiti,
     Headquarters Staff.            Headquarters

     All Deputy Commissioners Joint       Commissioner,
     & above                  Navodaya        Vidyalaya
                              Samiti, Headquarters.



7.   “Employer” means Navodaya Vidyalaya Samiti.
                                                                  3

8.    “Family” in relation to an employee, shall be deemed to
      consist of:-

      (i)    in the case of a male employee, himself, his wife,
             his children, whether married or unmarried, his
             dependant parents and the dependent parents of
             his wife and the widow and children of his
             predeceased son, if any;
      (ii)   in the case of a female employee, herself, her
             husband,     her    children,   whether   married    or
             unmarried,    her    dependant     parents   and    the
             dependant parents of her husband and the widow
             and children of her predeceased son, if any.

             Explanation :- Where the personal law of an
             employee permits the adoption by him of a child,
             any child lawfully adopted by him shall be deemed
             to be included in his family, and where a child of an
             employee has been adopted by another person and
             such adoption is, under the personal law of the
             person making such adoption, lawful, such child
             shall be deemed to be excluded from the family of
             the employee.


9.    “Superannuation” in relation to an employee, means
      the attainment by the employee of such age as is fixed in
      conditions of service as the age of on the attainment of
      which the employee shall vacate the employment.


10.   “Salary” means emoluments which are earned by an
      employee while on duty or on leave in accordance with
      the terms and conditions of his employment and which
      are paid or are payable to him in cash and includes
      dearness allowance but does not include bonus, house
      rent allowance, OTA and other allowances.
                                                                   4

III. Payment of Gratuity:


       (1)   Gratuity shall be payable to an employee on the
             termination of his employment after he has rendered
             continuous service for not less than five years, in the
             Samiti.



             i)        On his superannuation, or
             ii)       On his retirement or resignation, or

             iii)      On his death or disablement due to accident
                       or disease;


             Provided that the completion of continuous service of
       five years shall not be necessary where the termination of
       the employment of any employee is due to death or
       disablement.


             Provided further that in the case of death of the
       employee, gratuity payable to him shall be paid to his
       nominee or, if no nomination has been made, to his heirs.


             EXPLANATION : For the purpose of this rule,
             disablement means such disablement as incapacitates
             an employee for the work which he was capable of
             performing before the accident or disease resulting in
             such disablement.

       (2)   For every completed year of service or part thereof in
             excess of six months, the Samiti shall pay gratuity to
             an employee at the rate of fifteen days salary based
             on the rate of salary last drawn by the employee
             concerned .
                                                                                          5

                       Calculation of gratuity will be made as under:-


  Gratuity Payable =    Monthly salary last drawn X 15    X   No. of years of service
                                      26                      (part of a year in excess of 6 months
                                                              is counted as one year




            (3)             The amount of gratuity payable to an employee
                            shall not exceed three lacs and fifty thousand.




IV.     FORFEITURE OF GRATUITY


       Notwithstanding anything contained in sub-rule(1) of Rule III.

      i)     the gratuity of an employee                 whose services have been
             terminated for any act, willful omission or negligence
             causing any damage or loss to, or destruction of, property
             belong to the Samiti shall be forfeited to the extent of the
             damage or loss so caused;


      ii)    the gratuity payable to an employee may be wholly or
             partially forfeited;


             a)        if    the   service   of    such       employee      have     been
                       terminated by the Samiti for his misconduct or any
                       other act of violence on his part; or


             b)        if the services of such employee have been
                       terminated by the Samiti for any which constitute
                       an offence involving moral turpitude, provided that
                       such offence is committed by him in the course of
                       his employment.
                                                                                    6

V.        NOMINATION


          1.   A nomination shall be in Form “A” and submitted in
          duplicate by personal service by the employee, after taking
          proper      receipt   or    by    sending     through    registered     post
          acknowledgement due to the controlling authority.


               (i)       in the case of an employee who is already in
                         employment for a year or more on the date of
                         commencement of these rules, ordinarily, within
                         ninety days from such date; and


               (ii)      in the case of an employee who completes one year
                         of service after the date of commencement of these
                         rules, ordinarily within thirty days of the completion
                         of one year of service.


               Provided that nomination in Form “A” shall be accepted
               by the employer after the specified period, if filed with
               reasonable grounds for delay, and no nomination so
               accepted shall be invalid merely because it was filed after
               the specified period.


     2.        Within thirty days of the receipt of nomination in Form
     “A” under sub-rule (1), the controlling authority shall get service
     particulars of the employee as mentioned in the form of
     nomination,        verified     with   reference   to   the   records   of   the
     establishment and return to the controlling authority, after
     obtaining a receipt thereof, the duplicate copy of the nomination
     in Form “A” duly attested either by the controlling authority or an
     officer authorized in this behalf by him, as a token of recording of
     the nomination by the employer and the other copy of the
     nomination shall be recorded.
                                                                  7

3.       An employee may in his nomination distribute the
amount of gratuity payable to him under these Rules amongst
more than one nominee. In       such a case he shall specify in the
nomination the amount or share payable to each of the nominee
in such a manner as to cover the whole of the amount that may
be payable to him.


4.       If an employee has a family at the time of making a
nomination, the nomination shall be made in favour of one or
more members of his family, and any nomination made by such
employee in favour of a person who is not a member of his family
shall be void.



5.       If at the time of making nomination the employee has no
family, nomination may be made in favour of any person or
persons but if the employees subsequently acquires a family, the
employee shall make within ninety days of acquiring a family, a
fresh nomination in duplicate in Form “B” in favour of one or
more members of family and thereafter provisions of sub-rule (2)
shall apply mutatis-mutandis.


6.       A nomination may subject to the provisions of sub-rules
(3) , (4) and (5) of the above rule be modified by an employee at
any time, after giving to the Samiti a written notice, in duplicate,
in Form”C” of his intention to do so.


7.       A nomination or a fresh nomination or a notice of
modification of nomination shall be signed by the employee in the
presence of two witnesses, who shall also sign the declaration to
that effect in the nomination, fresh nomination or notice of
modification of nomination, as the case may be.
                                                                     8

  8.        A nomination, fresh nomination or notice of modification
  of nomination shall take effect from the date of receipt thereon by
  the controlling authority.


  9.        If a nominee predeceases the employee, the interest of
  the nominee, shall revert to the employee who shall make fresh
  nomination in duplicate in From “C” in respect of such interest.


  10.       Every nomination, fresh nomination or alteration of
  nomination, as the case may be, shall be sent by the employee to
  the Samiti, who shall keep the same in its safe custody.



VI.    Application for Gratuity:


  1.        An employee who is eligible for payment of gratuity
  under these Rules shall apply within thirty days from the date the
  gratuity become payable in Form “D” to the Samiti:


            Provided that where the date of superannuation or
  retirement of an employee is known, the employee may apply to
  the Samiti before thirty days of the date of superannuation or
  retirement.


  2.        A nominee of an employee, who is eligible for payment of
  Gratuity shall apply, ordinarily within thirty days from the date of
  gratuity became payable to him, in Form “E” to the concerned
  controlling authorities.


            Provided that an application on plain paper with relevant
  particulars shall also be accepted. The controlling authority may
  obtain such other particulars as may be deemed necessary by
  him.
                                                                      9

  3.        A legal heir of an employee who is eligible for payment of
  Gratuity under the rules, shall apply, ordinarily within one year
  from the date of Gratuity became payable to him, in Form “F”
  to the concerned controlling authority.


  4.        Where Gratuity becomes payable under these Rules
  before the commencement of these rules, the periods of limitation
  specified in sub-rules (1), (2) and (3) as given above shall be
  deemed to be operative from the date of such commencement.


  5.        An   application for payment of Gratuity filed after the
  expiry of the periods specified in this rule shall also be entertained
  by the controlling authority, if the applicant adduces sufficient
  cause for the delay in preferring his claim, and no claim for
  Gratuity under the Act shall be invalid merely because the
  claimant failed to present his application within the specified
  period.    Any dispute in this regard shall be referred to the
  Commissioner for his decision.

  6.        An application under this rule shall be presented to the
  Controlling Authority through the Head of the Office either by
  personal service or by registered post acknowledgement due


VII. MODE OF PAYMENT OF GRATUITY:

  1.        As soon as the gratuity becomes payable, the Controlling
  Authority shall, whether an application referred to in Rule VI
  above, has been made or not, determine the amount of gratuity
  and give notice in writing to the person to whom the gratuity is
  payable specifying the amount of gratuity so determined.


  2.        The Controlling Authority shall arrange to pay the
  amount of gratuity within thirty days after the date of receipt of
  the application to the person to whom the gratuity is payable.
                                                                   10


3.          Within 15 days of receipt of a notification under Rule (6)
for payment of Gratuity, the Controlling Authority shall;


     (i)    if the claim is found admissible on verification, issue a
notice in Form ”G” to the applicant employee, nominee or legal
heir, as the case may be specifying the amount of Gratuity
payable and fixing a date not being later than the 30 th day after
the date of receipt of application for payment thereof;
                                  OR
     (ii)   if the claim for Gratuity is not found admissible, issue a
notice in Form “H” to the applicant employee, nominee or legal
heir, as the case may be, specifying the reasons, why the claim
for Gratuity is not considered admissible.


4.          If the amount of gratuity payable, under sub-rule (1) is
not paid by the Controlling Authority within the period specified in
sub-section (2), the employer shall pay, from the date on which
the gratuity becomes payable to the date on which it is paid,
simple interest at such rate, not exceeding the rate notified by the
Central Government from time to time for repayment of long-term
deposits, as that Government may, by notification, specify.


     Provided that no such interest shall be payable, if the delay in
the payment is due to the fault of the employee.


5.          All Regional   Offices will estimate the budget required
every year for payment of Gratuity to the employees under their
jurisdiction and shall intimate in due course of time to the Finance
Wing of Navodaya Vidyalaya Samiti, Headquarters in the Forms
prescribed, as may be, along with the details for provision of
funds under head “Staff payment” sub head “Payment of
Gratuity”.
                                                                          11


  6.           The Gratuity    payable under this act shall be paid in
  Demand Draft or Bank cheque to the eligible employee/nominee
  or, legal heirs, as the case may be, by the Controlling Authority
  after      getting   concurrence   from   the   Finance   Wing   of   their
  respective offices.



VIII.        PROTECTION OF GRATUITY:

               No gratuity payable under these Rules shall be liable to
  attachment in execution of any decree or order of any civil,
  revenue or criminal court.


IX.          SETTLEMENT OF DISPUTES


        1.     If there is any dispute as to the amount of gratuity
        payable to an employee under these rules or as to the
        admissibility of any claim of, or in relation to, an employee for
        payment of gratuity, or as to the person entitled to receive the
        gratuity, the Samiti shall deposit with the controlling authority
        such amount as it admits to be payable as gratuity.


        2.     Where there is a dispute with regard to any matter or
        matters specified in clause (1), the employer or employee or
        any other person raising the dispute may make an application
        to the controlling authority for deciding the dispute.          The
        controlling authority shall, after due inquiry and after giving the
        parties to the dispute a reasonable opportunity of being heard,
        determine the matter or matters in dispute and if, as a result of
        such inquiry any amount is found to be payable to the
        employee, the controlling authority shall pay such amount or,
        as the case may be, such amount, as reduced by the amount
        already deposited by the employer.
                                                                                 12


     3.      APPELLATE AUTHORITY: In case of any dispute for
     payment of Gratuity, the Commissioner, Navodaya Vidyalaya
     Samiti shall be the Appellate Authority, who will record his
     decision on        receipt of     a memorandum of appeal from the
     claimant. A copy of the decision shall be given to the party to
     the appeal and copy thereof shall be sent to the controlling
     authority for further necessary action as per his decision


X.   Payment   of   gratuity   to  employees of   Central
     Autonomous Body/Public Sector Enterprises in case of
     their movement to Samiti and vice versa


     i.     In   case    an   employee        of   the    Samiti   joins     Central
            Autonomous Body/Public Sector Enterprises (PSE), with
            the consent of the Management of both, the gratuity
            payable to him in terms of Rule IV above, be paid to that
            Central Autonomous Body/PSE.


     ii.    The payment of gratuity under this Rule to PSE be made
            even in case the continuous service rendered by him in
            terms of Rule IV above is less than five years.


     iii.   In case an employee of any other Central Autonomous
            Body/PSE      joins      Samiti    with      the   consent      of   the
            Management of both, the service rendered by him in the
            previous Central Autonomous Body/PSE be reckoned for
            determining the continuous service in this Samiti provided
            the payment on this account in terms of Rule                   IV of the
            Rules is remitted to the Samiti.
                                                                          13


      iv.   For the purpose of (i)     and (iii) above the movement of
            employees from other Central Autonomous Body/PSEs to
            this Samiti and vice versa will be deemed to be with the
            consent of the Management of both if they are willing to
            make and receive payments towards leave and gratuity.


      v.    In case any employee, on movement from other Central
            Autonomous     Body/PSEs     to   this   Samiti   or   vice-versa
            receives or has received any payment towards gratuity
            and/or leave direct from the employer, the provisions of
            this rule, shall not applicable in his case.


XI.   SAVINGS


       Order     No.1-18/2001-NVS(Admn.)         dated     23rd.   November,
       2001 adopting the        Payment of Gratuity Act, 1972 for the
       employees of Navodaya Vidyalaya Samiti, mutatis-mutandis,
       with effect from 3rd. April, 1997 stands            withdrawn on the
       date of notification of this Rules.           However, all eligible
       employees of Navodaya Vidyalaya Samiti, including teachers,
       (who are otherwise not eligible to get gratuity paid under
       Payment of Gratuity Act, 1972) and who had become eligible
       for payment of Gratuity under the above order dated 23 rd.
       November, 2001 would be eligible for payment of Gratuity
       under the provisions of said Gratuity Act till the date of
       notification of these Rules and thereafter all claims for
       payment of Gratuity would be settled in accordance with the
       present rules.
                                                                     14


XII.     AMENDMENT/INTERPRETATION OF RULES


           Commissioner, Navodaya Vidyalaya Samiti may, by a
           notification make any amendment to these rules for the
           purpose of carrying out the provisions of these rules. Any
           question relating to interpretation of these rules shall be
           decided by the Commissioner Navodaya Vidyalaya Samiti.


 XIII.     REPEAL
           The provisions of these rules shall remain in force till such
           time the same is not inconsistent with the law that may be
           framed by the legislature in terms of law decided by Hon‟ble
           Supreme Court in Ahmedabad Private Primary Teachers
           Association vs Administrative Officer and Others 2004 (1)
           SCALE 368.


                                 -0------0-
                                                                                                          15
                                                FORM A
                                       (See Sub-Rule (1) of Rule-V)
                                         …………………………...

To……………………………………………………………………………..
  (Give here name or description of the establishment with full Address)

1.      Shri/Smt./Kumari…………………………whose particulars are given in the statement below.
                       (name in full here)

hereby nominate the person(s) mentioned below to receive the gratuity payable after my death as also the
gratuity standing to my credit in the event of my death before that amount has become payable, or having
become payable has not been paid and direct that the said amount of gratuity shall be paid in proportion
indicated against the name(s) of the nominee(s).

2.       I hereby certify that the person(s) mentioned is/are member(s) of my family within the meaning of
clause 8 of Rule II of NVS Payment of Gratuity Rules, 2007.

3.      I hereby declare that I have no family within the meaning of clause(8)of rule II of the said Rules.

4.      (a) My father/mother/parents is/are not dependent on me.
        (b) My husband’s father/mother/parent is/are not dependent on my husband.

5.      Nomination made herein invalidates my previous nomination.

                                                  Nominee(s)

        Name in full with full         Relationship with the       Age of nominee      Proportion by which
        address of nominee(s)          employee                                        the gratuity will be
                                                                                       shared
1.

2.

3.

4

so on

                                                Statement

1.      Name of the employee in full
2.      Sex
3.      Religion
4.      Whether unmarried/married/widow/widower
5.      Department/Branch/Section where employed.
6.      Post held.
7.      Date of appointment
8.      Permanent address
        Village……………………..Thana…………….Sub-division………………….Post Office……………….
        District……………………..State………………

Place                                                                                 Signature/Thumb impression
Date                                                                                  of the employee
                                                                                                           16
                                            Declaration by witnesses

Nomination signed/thumb impressed before me.

Name in full and full                                                                 Signature of witnesses.
Addresses of witnesses.

1.                                                                                     1.
2.                                                                                     2.

Place
Date



                                           Certificate by the employer

     Certified that the particulars of the above nomination have been verified and recorded in this establishment.

     Employer’s reference No., if any.

                                                                              Signature of the employer/
                                                                              Officer authorized
                                                                              Designation
                                                                              Date

                                                                              Name and address of the
                                                                              Establishment or rubber
                                                                              Stamp thereof.

                                      Acknowledgement by the employee

      Received the duplicate copy of the nomination in Form………………filed by me and duly certified by
the employer.




Date                                                                          Signature of the employer
                                                                                                           17
                                                FORM’B’
                                        [See sub-rule(5) of Rule V]

                                          Fresh Nomination

        To………………………………………………………………………….
          (Give here name or description of the establishment with full Address)

         I, Shri/Smt…………………(Name in full here) whose particulars are given in the statement below,
have acquired a family within the meaning of sub-rule 8 of Rule II of NVS Payment of Gratuity Rules, 2007
with effect from the ………………….(date here) in the manner indicated below and therefore nominate
afresh the person(s) mentioned below to receive the gratuity payable after my death as also the gratuity
standing to my credit in the event of my death before that amount has become payable, or having become
payable has not been paid direct that the said amount of gratuity shall be paid in proportion indicated against
the name(s) of the nominee(s).

2.       I hereby certify the person(s) nominated is a/are member(s) of my family within the meaning of
aforesaid Rules.

3.      (a) My father/mother/parent is/are not dependent on me.
        (b) My husband’s father/mother/parent is/are not dependent on my husband.

                                                 Nominee(s)

        Name in full with full          Relationship with the       Age of nominee     Proportion by which
        address of nominee(s)           employee                                       the gratuity will be
                                                                                       shared
1.

2.

3.

4

so on

                              Manner of acquiring a “family”
        [Here give details as to how a family was acquired, i.e., whether by marriage or parents being
                        rendered dependent or through other process like adoption.]

                                                Statement

1.      Name of the employee in full
2.      Sex
3.      Religion
4.      Whether unmarried/married/widow/widower
5.      Department/Branch/Section where employed.
6.      Post held.
7.      Date of appointment
8.      Permanent address
        Village……………………..Thana…………….Sub-division………………….Post Office……………….
        District……………………..State………………

Place                                                                                  Signature/Thumb impression
Date                                                                                   of the employee
                                                                                                            18
                                           Declaration by witnesses

Nomination signed/thumb impressed before me.

Name in full and full                                                                 Signature of witnesses.
Addresses of witnesses.

1.                                                                                      1.
2.                                                                                      2.

Place
Date



                                          Certificate by me employer

     Certified that the particulars of the above nomination have been verified and recorded in this establishment.

     Employer’s reference No., if any.
                                                                               Signature of the employer/
                                                                               Officer authorized
                                                                               Designation
                                                                               Date

                                                                               Name and address of the
                                                                               Establishment or rubber
                                                                               Stamp thereof.

                                      Acknowledgement by the employee

      Received the duplicate copy of the nomination in Form………………filed by me and duly certified by
the employer.




Date                                                                                 Signature of the employer
                                                                                                         19
                                                 FOR ’C’
                                        [See sub-rule(6) of Rule V]

                                  Modification of nomination

        To…………………………………………………………………………
          [Give here name or description of the establishment with the Address]

        I, Shri/Smt./Kumari…………….(Name in full here) whose particulars are given in the statement below,
hereby given notice that the nomination filed by me on [date] and recorded under your reference No……………
dated……………………shall stand modified in the following manner:

                              [Here give details of the modification intended]

                                          Statement
1.      Name of the employee in full
2.      Sex
3.      Religion
4.      Whether unmarried/married/widow/widower
5.      Department/Branch/Section where employed.
6.      Post held.
7.      Date of appointment
8.      Address in full.

Place                                                                               Signature/Thumb impression
Date                                                                                of the employee
                                            Declaration by witnesses

Modification of nomination signed/thumb impressed before me.

Name in full and full                                                               Signature of witnesses.
addresses of witnesses.

1.                                                                                  1.
2.                                                                                  2.

Place
Date
                                        Certificate by me employer

        Certified that the above modification have been recorded.
        Employer’s reference No., if any.
                                                                            Signature of the employer/
                                                                            Officer authorized
                                                                            Designation
                                                                            Name and address of the
                                                                            Establishment or rubber
                                                                            Stamp thereof.
                                    Acknowledgement by the employee

        Received the duplicate copy of the notice for modification in Form ‘H’ filed by me on……………duly
certified by the employer.

Date                                                                                 Signature of the employer

Note: Strike out the words not applicable
                                                                                                          20
                                                  FORM ‘D’
                                          [See sub-rule (1) of Rule VI]

                            Application of gratuity by an employee

                   To………………………………………………………………………….
                    [Give here name or description of the establishment with full Address]

Sir,

         I beg to apply for payment of gratuity to which I am entitled under sub-rule(1) of Rule VI of NVS
Payment of Gratuity Rules,2007 on account of my superannuation/retirement/resignation after completion of
not less than five years of continuous service/total disablement due to accident/total disablement due to
disease with effect from the ………Necessary particulars relating to my appointment in the establishment
are given in the statement below.

                                               Statement
          1.      Name of the employee in full
          2.      Address in full.
          3.      Department/Branch/Section where last employed.
          4.      Post held.
          5.      Date of appointment.
          6.      Date and cause of termination of service.
          7.      Total period of service.
          8.      Amount of wages last drawn.
          9.      Amount of gratuity claimed.

          I was rendered totally disabled as a result of

          [Here give the details of the nature of disease or accident]
          The evidences/witnesses in support of my total disablement are as follows:


                                                [Here give details]


          Payment may please be made in cash/open or crossed bank cheque.


       As the amount of gratuity payable is less than rupees one thousand, I shall request you to arrange for
payment of the sum due to me at the address mentioned above.


                                                                                             Yours faithfully,




Place                                                                        Signature/Thumb impression
Date                                                                         of the applicant employee.

Note: 1. Strike out the words not applicable.
        2. Strike out paragraph or paragraphs not applicable.
                                                                                                             21
                                                  FORM ’E’
                                         [See sub-rule (2) of Rule VI]
                                   Application for gratuity by a nominee


                To………………………………………………………………………………..
                   [Give here the name or description of the establishment with full address]
Sir,
         I beg to apply for payment of gratuity to which I am entitled under sub-rule (2) of Rule VI of the NVS
Payment of Gratuity Rules, 2007 as a nominee of late……………[name of the employee] who was an
employee of your establishment and died on the …………………..The gratuity is payable on account of the
death of the aforesaid employee while in service/superannuation of the aforesaid employee
on……………..retirement of/ resignation of the aforesaid employee on…………………after completion
of………………years of service/total disablement of the aforesaid employee due to accident or disease while
in service with effect from the …………………Necessary particulars relating to my claim given in the
statement below:
                                                   Statement


          1.       Name of applicant nominee.
          2.       Address in full of applicant nominee.
          3.       Marital status of the applicant nominee.
                   (unmarried/married/widow/widower)
          4.       Name in full of the employee.
          5.       Marital status of employee.
          6.       Relationship of the nominee with employee.
          7.       Total period of service of the employee.
          8.       Date of appointment of the employee.
          9.       Date and cause of termination of service of the employee.
          10.      Department/Branch/Section where the employee last worked.
          11.      Post last held by the employee with Ticket or Serial No., if any.
          12.      Total wages last drawn by the employee.
          13.      Date of death and evidence/witness as proof of death of the employee.
          14.      Reference No. of recorded nomination, if available.
          15.      Total gratuity payable to the employee.
          16.      Share of gratuity claimed.

2.     I declare that the particulars mentioned in the above statement are true and correct to the best of my
knowledge and belief.
3.        Payment may please be made in cash/crossed or open bank cheque.
4.       As the amount payable is less than rupees one thousand, I shall request you to arrange for payment
of the sum due to me by Postal Money Order at the address mentioned above after deducting Postal Money
Order commission there from.
                                                                                                Yours faithfully,


Place                                                                                  Signature/Thumb impression
Date                                                                                   of applicant nominee.

Note: 1. Strike out the words not applicable.
        2. Strike out the paragraph or paragraphs not applicable.
                                                                                                           22
                                                     FORM ‘F’
                                            [See sub-rule (3) of Rule VI]


                                     Application for gratuity by a legal heir


               To………………………………………………………………………………..
                 [Give here the name or description of the establishment with full Address]


Sir,
         I beg to apply for payment of gratuity to which I am entitled under sub-rule(3) of Rule VI of NVS
payment of Gratuity Rules,2007 as a legal heir of late………..[name of the employee] who was an employee
of your establishment and died on the…………..Without making any nomination. The gratuity is payable
on account of the death of the aforesaid employee while in service/superannuation of the aforesaid employee
on the……………. Retirement or resignation of the aforesaid employee on the…………….Necessary
particulars relating to my claim are given in the statement below:


                                                 Statement


        1.       Name of applicant legal heir.
        2.       Address in full of applicant legal heir.
        3.       Marital status of the applicant legal heir.
                    (unmarried/married/widow/widowers)
        4.       Name in full of the employee.
        5.       Relationship of the applicant with the employee.
        6.       Religion of both the applicant and the employee.
        7.       Date of appointment and total period of service of the employee.
        8.       Department/Branch/Section where the employee worked last.
        9.       Post last held by the employee.
        10.      Total wages last drawn by the employee.
        11.      Date and cause of termination of service of the employee (death or otherwise).
        12.      Date of death of the employee and evidence/witness in support thereof.
        13.      Total gratuity payable to the employee.
        14.      Percentage of the gratuity claimed.
        15.      Basis of the claim and evidence/witness in support thereof.

2.     I declare that the particulars mentioned in the above statement are true and correct to the best of my
knowledge and belief.
3.      Payment may please be made in cash/crossed or open bank cheque.
4.       As the amount payable is less than rupees one thousand, I shall request you to arrange for payment
of the sum due to me at the address mentioned below.

                                                                                              Yours faithfully,




Place                                                                        Signature/Thumb impression
Date                                                                         of the applicant legal heir.

Note: 1. Strike out the words not applicable.
                                                                                                           23
                                                      FORM ’G’
                                      [See clause(i) of sub-rule (3) of Rule VII]


                                             Notice for payment of gratuity


                    To……………………………………………………………………..
                      [Name and address of the applicant employee/nominee/legal heir]


        You are hereby informed as required under clause (i) of sub-rule (3) of Rule VII of NVS Payment
of Gratuity Rules,2007 that a sum of Rs……….(Rupees……………) is payable to you as gratuity/as your
share of gratuity in terms of nomination made by…………….on…………….and………………..Recorded
in     this………..         as     a     legal    heir    of……………………….an                    employee    of
this……………………..establishment.


2.      Please call at………………………..on………………..[date] at…………………for collecting.
                      [Here specify place]                              [time]


3.      Amount payable shall be sent to you at the address given in your application.


Brief statement of calculation.


        1.       Total          period         of          service          of         the          employee
                 concerned…………………years…………….months.
        2.       Wages Last drawn.
        3.       Proportion of the admissible gratuity payable in terms of nomination/as a legal heir.




                                                                                 Signature of the employer/
                                                                                 Authorized Officer
Place
Date


                                                                                 Name or description of
                                                                                 Establishment or rubber
                                                                                 Stamp thereof.

Copy to: The controlling authority:
Note: Strike out the words not applicable.
                                                                                                       24
                                                  FORM ‘H’
                                   [See clause (ii) of sub-rule(3) of Rule VII]


                               Notice rejecting claim for payment of gratuity


                 To………………………………………………………………………
                   [Name and address of the applicant employee/nominee/legal heir]


        You are hereby informed as required under clause(ii) or sub-rule (3) of Rule VII of Payment of
Gratuity Rule,2007 that your claim for payment of gratuity as indicated on your application in
Form………….…Under the said rules is not admissible for the reasons stated below:




                                                Reasons


                                      [(Here specify the reasons]




                                                                             Signature of the employer/
                                                                             Authorized Officer

Place
Date


                                                                             Name or description of
                                                                             Establishment or rubber
                                                                             Stamp thereof.

Copy to: The controlling authority:
Note: Strike out the words not applicable.